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Last October, I attended a lecture at the University of Toronto given by Mark Lewis, Ph.D., a neuroscientist and professor of developmental psychology. A former addict himself and author of The Biology of Desire: Why Addiction is not a Disease, Lewis said that addiction is not a disease, but rather an exaggerated outcome of normal learning. He also said that addiction is not caused by drugs or alcohol, it’s caused by attraction, where each cycle of attraction builds synapses in the brain that continue to narrow one’s focus to seek out immediate rewards rather than pursue longer-term opportunities. Proximity, availability and ego fatigue collude with the rewired brain to impair decision-making ability, blunting the sense of time that is normally part of our sense of self and who we are striving to become.

Wasted

This Thursday, January 21, 2016, CBC’s The Nature of Things will air the documentary Wastedat 8:00 p.m. The show chronicles the journey of Mike Pond, a successful psychotherapist from Penticton, B.C. and an alcoholic-in-recovery, as he discovers new evidence-based addiction research and treatment options.

Filmmaker Maureen Palmer and Pond originally set out to help others battling substance abuse by filming his progress after his five years of sobriety. But shortly after filming began, Pond relapsed and drank again. Pond had been at rock bottom before: he lost his practice, home and family, and had ended up homeless in Vancouver. This new challenge brings a personal and real-time urgency to their quest to find a treatment that could work.

Alcoholics Anonymous doesn’t work for most people

The only treatment offered to Pond at the time was Alcoholics Anonymous (AA). No surprise there, since most people, including frontline healthcare providers, still believe AA is the only effective treatment for addiction.

But the program didn’t work for Pond. In fact, it doesn’t work for a majority of people with addiction problems, and those who can’t work the twelve steps often feel like failures, especially when “success” is defined as total abstinence. Dr. Bill Miller, Professor Emeritus at the University of New Mexico and one the world’s foremost addiction experts, argues for a radical shift in thinking. He looked at large data sets on outcomes of alcoholism treatment programs in the U.S. and found that one in four people had abstained for a year after treatment. For the other 75% who did drink in that year, their alcohol consumption was down by 87%. He says, “Now for any other chronic condition, a 25% complete remission and an 87% reduction in symptoms for everybody else would be astonishingly successful. We really disadvantage ourselves by saying you’re a failure if you have even a single recurrence of what was the reason why you were admitted in the first place.”

Brain research clues

After years of recriminations and feelings of shame and failure with his recent relapse, Pond says, “I don’t want to go get a drink. I want to go and get the effect of that drink.” He is relieved to learn that his brain is wired differently and that his addiction is not a lack of willpower. His score on a computer game to test the ability for self-control showed he has a high level of impulsivity. When he viewed pictures of alcoholic and non-alcoholic drinks while in an fMRI machine, he reported that he didn’t have cravings when looking at the pictures of booze, yet his brain images told a much different story. His brain showed increased activity in the same areas as a small group of people with alcohol dependence issues.

Image courtesy of CBC’s The Nature of Things.

New drug options for addiction

Pond travelled to Bellingham, Washington for a new drug treatment called naltrexone (Vivitrol), an injectable medicine that can block or blunt cravings for up to 30 days. The drug is not yet available in Canada as an injectable and the pill form is apparently rarely prescribed. According to the manufacturer Alkermes’ website, studies showed that patients who received the drug plus counselling experienced significantly fewer days of heavy drinking. The drug is intended for people who have stopped drinking large amounts of alcohol to help them avoid drinking again and is to be used together with counselling and social support. And some people, like Pond, have a genetic predisposition to respond better to the drug.

Another medication mentioned in the film is gabapentin; a drug primarily used to treat seizures and neuropathic pain but also for anxiety disorders, insomnia, hot flashes and bipolar disorder.

Watch the film to find out what happens

I’ve watched it and I think Wasted is an important documentary to reduce the stigma associated with addiction and encourage more people to get help. How we define success matters greatly. Our healthcare system needs to ensure that people dealing with addiction can access the range of evidence-based treatments that are now available, including medications and cognitive behavioural therapy.

No one should get kicked out of treatment for relapsing. I recall Mark Lewis saying in the lecture I attended last October that one of the most powerful ways to help addicts is to empower them in their recovery, utilize their desire for other goals and help them envision a future that looks beyond the immediate to see their life as a narrative that can move from the past to the present to the future. That Pond can reconnect with his motivation and his reasons for moving forward bodes very well for his continued recovery. Kudos to Pond and Palmer for filming his journey so that it may help others!

Bountiful Films and partner Magnify Digital are launching Addiction The Next Step, an online portal for families and loved ones of those battling substance abuse. It has an interactive guide with proven therapy and information about how to communicate in a manner that motivates a substance abuser to change while reducing family stress and fear.

Invisibilia is Latin for “all the invisible things,” those things we might never consider if it were not for these two intrepid podcasters delving in to some interesting reporting journeys to shine a light on them. In the pilot season, they explore our innermost thoughts, emotions, and expectations and track down the science to help explain how those things impact on us.

The storytelling is superb. Each episode is laced with new findings from the fields of psychology and brain science, which for me is brain candy.

I was particularly thrilled to listen to How to Become Batman in this past Friday’s episode. About four years ago I wrote Echolocation Helps Blind People Navigate Everyday Life for GE’s Healthy Outlook blog so I am familiar with the science behind how blind people use echolocation to see. But it was wonderful to hear more detail, the backstory of Daniel Kish’s life and listen to the same neuroscientist I interviewed share her remarkable findings about what happens in his brain when he uses echolocation to navigate the world.

Kish shares some wise thoughts on the expectations we impose on others we perceive to have disabilities. If you have time, there is a bonus segment that details the experience of a blind woman who echolocates. Her story makes us consider the other side of the coin and is a poignant story about trading roles with her husband as their situation changes.

If you haven’t checked out Invisibilia yet, I highly recommend you do.

Do you know someone who has a fear of holes just looking at Cheerios, Swiss cheese, or Aero chocolate bars? If so, you may have already heard about a phobia called trypophobia.

As reported by NPR, 16 per cent of the 286 adults who participated in a recent study reacted with anxiety and revulsion to images of clusters of holes. The study was published in the journal Psychological Science.

Study authors Geoff G. Cole and Arnold J. Wilkins at the Centre for Brain Science, University of Essex state, “We argue that although sufferers are not conscious of the association, the phobia arises in part because the inducing stimuli share basic visual characteristics with dangerous organisms, characteristics that are low level and easily computed, and therefore facilitate a rapid nonconscious response.”

In other words, these researchers suggest that there may be an evolutionary basis at work that produces a fear response, similar to the response caused by images of dangerous animals like leopards, king cobra snakes or blue-ringed octopuses that display visual markings with “high contrast energy at midrange spatial frequencies.” In the study, even people who are not trypophobes reacted more negatively to images of patterns displayed by dangerous animals.

While it might be difficult to understand how Swiss cheese could freak someone out, this fear certainly causes distress for those who suffer. On the Facebook page for Trypophobia.com, one woman shares her fear of garlic, “But I roast garlic a lot for cooking. And I have to cut the bottom off the garlic bulb exposing all the little garlic cloves inside to roast it. And man, it gives me the heebie freakin jeebies every time. Anybody else have that experience?”

I’ve never known anyone yet who has trypophobia and I’m skeptical that the 16 percent figure is a bit high compared to the average prevalence of phobias running around 9 per cent, and phobias for snakes and spiders affect about 3-6 per cent.

Coincidentally, this study was published a couple of weeks before the new iPhone 5 models were hitting the market. I’ll bet that trypophobes who buy the new iPhone 5C will take a pass on the new case, which has holes on the backside.

Concussion season began with a head bang last night in the NHL season opener as Montreal Canadiens player George Parros was knocked unconscious during a third-period fight with Toronto Maple Leafs player Colton Orr. Parros was transported off the ice on a stretcher. He suffered a concussion and is reported to be out of the game indefinitely.

Cue the debate about whether hits to the head are “part of the game” or a serious health issue that needs to be addressed to prevent players from suffering from the short-term and long-term effects of head trauma. On the one hand, gladiator-style action drives ticket sales — I’ll never forget how the audience rose to cheer two players punching each other in the head in a fight at the first live Toronto Maple Leafs game I attended. Outside the rink, only a few hundred feet away, this behaviour would have been considered assault.

A concussion is what happens when the brain slams into the skull, whether from a blow to the head or from violent shaking. As Sidney Crosby knows only too well, concussions can ignite a cascade of symptoms that last for months or even years after the original injuries. It’s tricky to diagnose concussions on the spot because some people, but not all, lose consciousness, vomit or have difficulty with mental or physical coordination. Other symptoms include headache, attention problems, dizziness, memory loss, depression and anxiety.

Chronic traumatic encephalopathy

Chronic traumatic encephalopathy (CTE) is a progressive brain disorder that results from repetitive head injury like multiple concussions, causing headaches, depression, aggression and ultimately debilitating dementia. Check out this New York Times video to see how in CTE, tangles of damaged tau proteins spread throughout the brain.

Currently, CTE can only be diagnosed by examining the brains of people who have died. Researchers at the Boston University School of Medicine together with Sports Legacy Institute (SLI) created the Center for the Study of Traumatic Encephalopathy, a world-first centre that analyzes brains of deceased professional sports players and veterans. SLI Medical Director Robert Cantu MD says, “One of the things that we know without question is that no head trauma is good head trauma. You cannot condition the brain to take trauma, you can only injure it.”

Meet co-director Chris Nowinski, former pro-wrestler and NFL player who has had multiple concussions and now focuses on working for a solution. He figures he has about 12 years left before “he has lost so much tissue that there’s no turning back.”

In recent years, several unfortunate head injuries to high profile hockey players have drawn more attention to the risks of concussion. The NHL introduced Rule 48 in 2010-11 regulating bodychecking, making it illegal to target an opponent’s head from the blind side. The rule was modified in 2011-2012 to include all hits to the head, although a referee can still determine whether the hit player put himself at risk. In a recent study looking at three seasons of play though, researchers found that Rule 48 did not make a difference in the overall number of concussions and that most concussions resulted from ‘legal actions’.

Protecting the players will take much more than tweaking the rules. It’s thrilling to watch contact sports, but as more players get hurt and more is known about the risks of head injury, we have to question exactly what it is that we are sanctioning. I can’t think of another profession where getting hit in the head is considered part of the job and cheered on by others.

Could cocoa really be the brain drug of the future by improving cognitive function in the elderly?

Hope springs eternal for studies trying to find that chocolate is good for you! Researchers at the University of L’Aquila in Italy with scientists from Mars Inc. (that’s right, the candy company) conducted a study among elderly people with mild cognitive impairment to see if consuming specially prepared cocoa drinks would improve their cognitive function.

In the study, 90 adults with mild cognitive impairment drank a cocoa beverage with either low, moderate or high levels of flavanols daily for 8 weeks. Those who imbibed moderate or high levels of flavanols showed improvements in verbal fluency, visual searching and attention. The high consumption group also showed decreased insulin resistance and blood pressure.

So can we eat lots of chocolate now, with this latest headline proclaiming a health benefit we really, really want to believe, validating a vice?

Well, no, at least not until that special cocoa beverage is available. You would have to eat 10-20 bars of 1-1.5 oz chocolate bars daily to achieve the same consumption of flavanols that the research subjects consumed, according to the post in Scientific American. Besides, the added sugars and fats would likely offset or negate any gains in insulin resistance from the flavanols.

Those flavanols are also found in tea and apples. But tea or apples in the headline wouldn’t get as many web hits, right? Besides, the study wasn’t really about chocolate, but rather a compound found in chocolate.

For more health writing follies about the health benefits of chocolate, check out this abstract of an ‘Occasional Note’, published in the New England Journal of Medicine last October: Chocolate Consumption, Cognitive Function and Nobel Laureates by Franz H Messerli, MD. The full article is behind a pay wall, but you can read all about it in this Reuters post, Eat chocolate, win the Nobel Prize?, to see how the author was making a spectacular example of how the media often draws faulty conclusions on observational studies.

Physical ability is one thing, but new research suggests that professional athletes have higher visual processing intelligence. The ability to process complex dynamic visual scenes is what separates them from the pack.

The study compared the performance of 308 people using NeuroTracker, a visual processing program that measures how participants respond to different identification tasks after tracking balls on a screen that are bouncing and weaving among decoys. The study was recently published in Nature Scientific Reports.

Three groups were studied:

102 participants, professional athletes from the NHL or top tier soccer or rugby teams

173 elite amateurs, competitors from the U.S. National Collegiate Athletic Association or athletes who trained at a European Olympic training centre

33 non-athletic university students

Participants completed 15 training sessions over at least five days and researchers measured both how quickly and how much they improved their performance.

All groups improved performance with training, but professional athletes learned faster and did significantly better than elite amateurs and non-athletes.

Professional athletes as a group have extraordinary skills for rapidly learning unpredictable, complex dynamic visual scenes that are void of any specific context. It is clear from these results that these remarkable mental processing and learning abilities should be acknowledged as critical elements for world-class performance in sport and potentially elite performance abilities in other dynamic contexts.

As reported in The Globe and Mail, study author and principal investigator Jocelyn Faubert from the University of Montreal says,

They have a special intelligence. And that’s an intelligence to be able to manage many, many things when it’s dynamic and difficult to follow and do it really fast. And they manage to learn it a lot better than anybody else.

Jocelyn Faubert is director of the visual psychophysics and perception laboratory at the University of Montreal and is also chief science officer at CogniSens Athletics Inc., which has licensed NeuroTracker.

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